Diabetes Flashcards
1
Q
Diabetes Types
A
- 1, 2, gestational
- Maturity onset diabetes of the young
- Secondary (1-2%), pancreatic disease, endocrine disease
2
Q
Diabetes T1
A
- Genetic predisposition and autoimmune process, usually pre-diabetic phase, antibodies can be detected as early as 6-12 months
- Triggers include viruses, dietary factors, stress
- Can occur at any age
3
Q
Diabetes T2 Epidemiology, Cause, Presentation, RFs
A
-85% of those with diabetes
-Excess body weight and physical inactivity
-Increased prevalence in some ethnicities
-Gradual onset
-Those with T2DM may eventually need insulin treatment
RFs
-Obesity, lack of physical activity, ethnicity, PHx of GeD
4
Q
Diabetes Presentation
A
- Polyuria, polydipsia, lethargy, boils, pruritus vulvae, frequent or prolonged infections
- T1 may cause weight loss, dehydration, ketonuria, hyperventilation, presentation tends to be acute
5
Q
Diabetes Diagnosis
A
- HbA1c can be used as a diagnostic test
- 48 is cut off but a value less than this does not exclude diabetes
- Type 2 can also be diagnosed with fasting blood glucose level of 7.0 or greater
- If asymptomatic, don’t base on one test
- If symptomatic, diagnosis can be based on one test
6
Q
Diabetes Complications
A
- CVD, PAD
- Nephropathy (keep blood pressure below 130, ACEi)
- Neuropathy (neuropathic painkillers, treat each autonomic symptom individually)
- Retinopathy (keep BP<130, ACEi, laser treatment)
- Foot ulcers
7
Q
Diabetes T1 Management
A
- Hx, examination (general, BMI, feet, eyes, BP, peripheral pulses)
- Ix; ACR, HbA1c, eGFR, TFTs, lipids, coeliac
- Refer to hospital
- Diet, activity
- Twice daily or multiple injection regimes
- Twice daily for those who require assistance or dislike injecting
- Multiple injections for well-motivated individuals with good understanding
8
Q
Diabetes T2 Management
A
- Metformin
- Until HbA1c over 58
- Add second
- If over 58 add third
- If still over, set personalised target
